Expanding Medicaid is wrong solution

The Obama administration is threatening to withhold over a billion dollars from Florida hospitals.
Why else but to pressure Florida’s Legislature to embrace Obamacare and dramatically expand our Medicaid program.

We need reform that gives patients more control and achieves better health outcomes, not more bureaucracy. Medicaid expansion takes us in the wrong direction.

Here are some reasons my colleagues and I vigorously oppose Medicaid expansion in Florida:

■ Medicaid expansion hurts the working poor. Someone who works even 28 hours per week at minimum wage is eligible for significant subsidies for private insurance under the exchange. Accepting Obamacare’s Medicaid expansion would force these same Floridians to lose their private insurance and be dumped into Medicaid’s bureaucracy.

■ A recent Oregon study found that people on Medicaid had no better health outcomes than the uninsured. Medicaid is a dysfunctional system, and we should not expand it without major reforms.

■ When you hear about the $54 billion we are “giving up,” the federal government must borrow its share of those funds — about $51 billion — for Medicaid expansion.

Why deliberately become more dependent on borrowed federal dollars by accepting Medicaid expansion? When (not if) the borrowing ultimately stops, Floridians will face the real costs of Medicaid expansion.

■ Already, the federal government has proven willing to cut state funding. When passed, Obamacare threatened states with a Hobson’s choice: Take Medicaid expansion or lose billions in federal funds for existing Medicaid recipients. This would have wrecked state budgets, including Florida’s, and given legislators little choice but to accept expansion.

The U.S. Supreme Court intervened and called this threat an unconstitutional “gun to the head.” The court ruled the federal government could not coerce states to expand Medicaid by withdrawing existing funds.

Yet today the Obama administration threatens to cut more than $1 billion in federal funding for our hospitals (known as the Low Income Pool). Relying on the court’s prior ruling, Florida has filed suit to protect its citizens. Given its track record, we simply cannot trust the federal government to be a good faith partner.

While Medicaid expansion would take us in the wrong direction, the Florida House has pursued bipartisan measures to reduce costs and improve health outcomes.

For example, the House would allow primary care doctors to lower the cost of doctor visits by contracting directly with their patients, avoiding the dual bureaucracies of insurance companies and government.

We support telemedicine, so patients can connect remotely with providers, improving access for patients who live too far or lack transportation to the health care provider they need.

Additionally, we support expanded options for patients to use ambulatory surgery centers and recovery care centers for common surgeries and post-op recovery. These facilities are far less expensive than traditional hospitals and represent another real reform that can reduce health costs.

Republicans in the House are promoting innovative ideas that empower patients and their providers. We want a better Florida, not a bigger bureaucracy.

By moving in the right direction — and away from Obamacare’s sclerotic bureaucracy — we can reduce costs, expand access and improve health outcomes for every Floridian.

Paul Renner is a Republican state representative from Northeast Florida.

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